The brow lift is a basic procedure for rejuvenating the upper portion of a patient's face. The brow lift procedure may be used to elevate the eye brows, remove or lessen forehead wrinkles, reduce frown lines, smooth the nasion and elevate the nasal tip. These results are generally achieved by elevating the top of the patient's brow from the skull and suspending the brow in a superior position for a sufficient period of time so that the soft and connective tissues of the patient's scalp knit in place, leaving the patient with the desired effects.
In the past, surgeons performed invasive surgery using standard surgical tools at open surgical sites, typically performing a bicoronal incision with subgaleal dissection, to complete a brow lift procedure. These techniques were very limited in their application and resulted in significant scarring to the patient.
More recently, surgeons have begun to use endoscopic techniques to perform brow lift procedures. Endoscopic procedures allow the surgeon to make a small incision or incisions, extend surgical tools through the small incisions and perform the procedure while viewing the surgical site with an endoscope. In this manner, the brow lift procedure is performed without the need for large surgical incisions that are required in open surgical techniques.
Once the surgeon has moved the brow to a superior position, the soft tissue must be suspended in that position for a sufficient time to allow healing to occur. External means, such as screws and staples, have been used to suspend the soft tissue in place. These devices may leave the patient susceptible to infections, require a great deal of bandaging and leave extensive scars. More recently, internal means, such as surgical pins or posts, have been applied. These devices work for their intended purposes, but they require the surgeon to reopen the skin to remove them and they can create an internal space which is susceptible to undesirable effects such as fluid collection.
Additionally, tissue fixation methods that do not a require reopening of the patient's skin to remove fixation devices have been attempted, including bone tunneling and deployment of resorbable fixation devices. Bone tunneling involves drilling two interconnecting holes into the patient's cranium and leaving a "bridge" between the holes. A suture thread may then be routed though this tunnel and used to fix the patient's scalp tissue in place. Despite the strength of cranial bone, this method can be difficult to perform without weakening or breaking the bone "bridge" that fixes the suture thread to the cranium. Resorbable fixation devices also have drawbacks, including the inability to adjust the timing of the fixation device's release after implantation in response to individual healing rates and the creation of internal spaces as with surgical pins or posts.